Drug & supplement interaction

Elderflower + Rivaroxaban

Rivaroxaban brand name: Xarelto.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Elderflower and Rivaroxaban in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Elderflower and Rivaroxaban

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Rivaroxaban and Elderflower in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Elderflower safety at a glance

Elderflower overall Use caution Properly prepared flowers are generally well tolerated, but raw plant parts can be toxic.
Pregnancy Avoid There is not enough reliable safety information, so it is best to avoid.
Breastfeeding Avoid Safety has not been studied, so avoid unless your doctor approves.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Rivaroxaban and Elderflower? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Rivaroxaban

Interactions in our licensed database are recorded against drug classes, not just single drug names. Rivaroxaban is filed under 5 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Elderflower has documented interactions with 1 drug class — the most serious being antidiabetes drugs (moderate) — and none of Rivaroxaban’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Elderflower Does Interact With Other Medications

Elderflower has 86 moderate known drug interactions in our database — Rivaroxaban isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Elderflower

Covers the 2,830 medications we’ve checked against Elderflower. Pick one to open its full report.

What to actually watch for

What Elderflower Itself Has Been Linked To

This is not an interaction — nothing below involves Rivaroxaban. It is the side-effect record for Elderflower on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Elderflower, this list is the first place to look.

  • Diarrhea Additional detail

    “Diarrhea and colic have been reported after drinking a tea made from elderflower, anise fruit, fennel fruit, and senna flowers. It is not clear if these effects were due to elderflower or the other ingredients.”

    Elderflower · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 49494. Picon, P. D., Picon, R. V., Costa, A. F., Sander, G. B., Amaral, K. M., Aboy, A. L., and Henriques, A. T. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for

Everything above comes from the Natural Medicines adverse-effect record for Elderflower — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Rivaroxaban’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Rivaroxaban column appears here.

From our Q&A

Questions About Elderflower or Rivaroxaban

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Elderflower or Rivaroxaban, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Rivaroxaban

This page covers Elderflower only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rivaroxaban page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Rivaroxaban page

“Grapefruit is the interaction I would flag first for anyone taking rivaroxaban (Xarelto). It slows how the body clears this blood thinner, and higher levels mean more bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Rivaroxaban interaction page

How much people look this up

Where Elderflower and Rivaroxaban Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Elderflower
Steady interest

#1,399 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Rivaroxaban
Top 10

#10 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Elderflower reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Elderflower and Rivaroxaban records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Elderflower

What is Elderflower?

  • Colds and flu
  • Sinus congestion
  • Fever and sweating
  • Sore throat
  • Coughs

Elderflower comes from the elder plant (Sambucus nigra) and is traditionally used as a tea or extract for colds, sinus congestion, and fever. Good-quality human evidence is limited, so it should be seen as a soothing traditional remedy rather than a proven treatment. Raw or unripe parts of the plant can be toxic, so use only properly prepared products, and check with your pharmacist or doctor first.

Sambucus nigra · Adoxaceae · Dried flowers · Tea, liquid extract, tincture, capsules, syrups, lozenges

An interaction check asks whether these two react with each other — it does not ask whether Elderflower is a good idea for someone in your situation. Here is what our Elderflower record says about it on its own.

Elderflower: dosing

There is no official standardized dose for elderflower. The right amount depends on the product, its strength, and how it is prepared (tea, extract, or tincture).The safest approach is to follow the directions on the product label and not exceed the recommended amount.

From our Elderflower monograph — the full record covers uses, side effects and every documented interaction.

Read the full Elderflower monograph & all interactions
Medication

About Rivaroxaban

What Is Rivaroxaban Used For?

Brand name: Xarelto

Rivaroxaban tablets are used to reduce the risk of stroke in adults with nonvalvular atrial fibrillation (an irregular heart rhythm), treat deep vein thrombosis (DVT, a blood clot in a vein) and pulmonary embolism (PE, a blood clot in the lungs), and lower the chances of these clots coming back. They also help prevent clots after hip or knee replacement surgery, protect hospitalized patients at risk for clots, and — in combination with aspirin — reduce the risk of major cardiovascular events in adults with coronary artery disease (CAD) or peripheral artery disease (PAD).

Rivaroxaban tablets are also approved for treating VTE (venous thromboembolism, blood clots in veins) and preventing recurrence in pediatric patients from birth to under 18 years, and for preventing clots in children aged 2 and older with congenital heart disease after the Fontan procedure. Rivaroxaban for oral suspension (available as Rivaroxaban Granule and Xarelto oral suspension) is specifically indicated for these two pediatric uses.

See full Rivaroxaban drug information
Keep checking

Other Drugs & Elderflower

Browse every other medication we’ve checked against Elderflower — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
86Moderate
0Minor
2,743No known interaction
Moderate

86 interactions

Showing 60 of 86 moderate interactions — see all 86 on the Elderflower page.

No interaction 2,743 drugs checked — show the list
Evidence & sources

Elderflower References

The 2 references that drive our Elderflower monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gray AM, Abdel-Wahab YH, Flatt PR. The traditional plant treatment, Sambucus nigra (elder), exhibits insulin-like and insulin-releasing actions in vitro. J Nutr 2000;130:15-20. PubMed
  2. Picon, P. D., Picon, R. V., Costa, A. F., Sander, G. B., Amaral, K. M., Aboy, A. L., and Henriques, A. T. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Elderflower and Rivaroxaban Together: Common Questions

Is it safe to take Elderflower with Rivaroxaban?
We do not list a known interaction between Elderflower and Rivaroxaban. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
How was the Elderflower and Rivaroxaban combination checked?
Interactions in our licensed database are recorded against drug classes. Rivaroxaban is filed under 5 classifications, and Elderflower has documented interactions with 1 drug class — none of Rivaroxaban's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Elderflower interact with any other medications?
Yes. Elderflower has 86 documented drug interactions in our database — Rivaroxaban is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Rivaroxaban interact with any supplements?
Yes. Rivaroxaban has documented interactions with 285 supplements in our database — Elderflower is not one of them. The Rivaroxaban interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Rivaroxaban and Elderflower?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.